OCD: A Clients Journey To Recovery

ocdYears ago I had worked one on one with a client who suffered from OCD (obsessive-compulsive disorder).  This particular gentleman was my first experience working with someone with extreme checking and rituals.

The two primary triggers for his checking and rituals was driving and walking in crowded public areas.

Driving was his main concern.  So we began working on his driving behavior first.

From the moment he started driving he would start to question if something bad happened. Did he hit a person?  Did he hit another car?  All leading up to the “what if” he did something wrong and the police are going to look for him to arrest him.

So his anxiety driven thoughts began from the moment he pulled out of a space.  By the time he got to the corner, he convinced himself that something had happened and he had to go back and see how bad it was.  This resulted in him going around the block.

Problem is, once he went around the block, there are no other streets involved and maybe something happened on those streets.  So even though once he got back to the original street where he started and realized nothing happened there, he still had to worry about whether or not something happened on the other streets he drove down.

The cycle was endless.  And he would spend a minimum of 30 minutes each morning driving around the block before he could begin driving on other roads to get to work.  Throughout the entire drive to work he would listen for anything that sounded like he hit something, and if needed he would go back and check to make sure everything was ok.

This type of behavior was very similar to what would happen while walking in the crowded public places as well.  He wasn’t worried that he hit someone or something with his car, but he was worried that he did something that would cause him to be arrested.

Keep in mind that this gentleman was a very good driver.  I drove with him many times over a 9-week period, and not once did I ever question his driving ability.  Likewise, I spent hours with him walking around a mall and not once did he ever display any kind of behavior that would make me worry about him in public.

His fear was like any other person suffering from anxiety disorders; irrational “what if” thoughts of the future.

Recovery for this gentleman was the same that it was for me and everyone else.  We had to create a new conditioning in his behavioral response to his triggers.  To do this we used the same tools as I have listed on previous posts (physical tools & mental tools).

OCD is slightly different than other manifestations of anxiety disorders in the sense that the thoughts come faster.  The way that I visualize OCD is like a spinning top.  Actually, if we look at all anxiety as a spinning top most other manifestations of the disorder spin at a “slower” rate.  So with the slower spinning top, it is a little easier for the tools to work at first.  With OCD imagine the spinning top going much faster.  With the faster speed, it is more difficult to get the tools to work at first.  However, with OCD once the tools are able to get in and be effective, the spinning stops quicker.  We just have to interrupt the spinning enough so that it kind of collapses on itself.  (I hope that makes sense)

With this gentleman in working on his driving, I had him begin using his tools before he left his house.  Physical tools worked best for him; strong flavored mints & gums, and ice cubes mostly were used.  And I had him literally drive from one parking space to another.  Park the car and go back inside.

Small, manageable steps.  And exposure to his trigger without feeding his fear.  He was able to do this practice and desensitize himself to his trigger.  He was able to get in his car, drive (even if a very short distance) and see the reality that everything was fine.

Little by little the practice distances went from one end of the street to the other.  Then turned a corner.  In a relatively short period of time, he was driving around the block with almost no fear.  Yes, he still had to use his tools, and there were still thoughts of “what if”, but his behavioral response to these thoughts had changed drastically.

In addition, we began working at a shopping mall as well.  Same small, manageable approach to exposure.  Using the tools and gradually being exposed to larger crowds of people for short periods of time; same approach as the driving.  Again, in the same period of time as the driving, his behavioral response to crowds had changed drastically as well.

Over the years I personally worked with many people who suffered from OCD.  In addition, I knew many other stories that I got to learn how OCD manifested and how recovery was approached.

Regardless of the trigger, and regardless of the checking or ritual, the approach to recovery was all the same.  Using physical and mental tools to break the conditioned pattern of thought based on irrational fear, and create a new conditioned pattern of thought based on reality.

Never give up!  Persistence!

 

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